|
ii=177,IF 9=07Z H CONSOLIDATED Rim l
<br /> 0NFPlit R(,MUMJNV STT)RAGETAN K
<br /> -TANK INFORNIXTION
<br /> FERM1,17APPLk �cdon and Secti ns 1, !!
<br /> Ill.IV,nnd t7 I.clow, 130
<br /> 011.111V Or reit this
<br /> �OFIAC'rlol'[ (n)CCIf one item only� 114'I permanent.cl 7.nnietconly ' 0
<br /> TY117 10, 5.4:14AN(R�OF lj',IFORMA'�4�1
<br /> I .RF,Nf:AVAf` PFRiMIT
<br /> ["J' 8,1 IST R[!"MOVAI
<br /> 6�TEMPORARY UST.,C1,0�,10RI;......
<br /> m73N, fit
<br /> Use 017�y)
<br /> FA( IT)iy(Age)fc
<br /> -----------
<br /> 13uSiuc55 As)
<br /> COW CIA` Iti I
<br /> SS
<br /> 03 i
<br /> Nub ucl
<br /> YLIPANK DESCRIPTION
<br /> 434
<br /> TANK MANUFACTURER 413 TANIC
<br /> TANK 101f I.lA!;VJ'AND--AI ONh ETANK
<br /> )J2,ONE INA COMPAPTMENTED U N11
<br /> Co
<br /> t.a--''----.,--.--.-, _,F,11 -116 1\1(j OMPARTME iNT1 if.
<br /> iNSTALLFr,
<br /> _aq
<br /> USE AND CONTENTS
<br /> aMOTOR V1,H]CLEXUPLINGIb.
<br /> ------ a 1c.AVIATION ruF.T.,imi
<br /> H IT;]INC-
<br /> .
<br /> I b.MARINA
<br /> WAS'l F(mcindc, 11-04) 5.1�,MFJ�GTNCY(,rNFTAT01Z Ft
<br /> fIAXARDOUS 43%
<br /> 1:] 99-OLRFR (Specify) F40
<br /> 1b.PRF*MIT IM LINLEADED
<br /> -•(,Oj\j,T,Ej\j,rS Pr 6.AVIATION GAS
<br /> 3.DIESEL 5''fuX I m), &12 � 140a
<br /> ❑ 9 0 . :.Iri� ' I
<br /> I-PFTROLEI M, 131,FNI)1:1 If 0 L IH I i A
<br /> _NON-PF'rR0T,j:(IM:0 7.USED OPI. j0j-"PXJAf\f0L 4401)
<br /> Ej 11.OTHER NON-PHT'R01,1`11M S)cjeify
<br /> 'CTION
<br /> TV. TANK CONSTRU
<br /> 443
<br /> TYPE OF TANK ELj_M(LjWALL ,:_3OUBjE WALL,
<br /> E )WN
<br /> 444
<br /> PRIMARY-CONTAINMENT ❑ I STEEL -3-rim I I,A�� n 6.TNTFRNAL BLADDER 444a
<br /> 77 S'FF.Ef, INTERNAL KING ❑ 95i.IINKNOWN C] 99.OTHER (Spcci
<br /> 445
<br /> 1,F
<br /> (i�N7FAINMFNT 0 1,STEEL-1K3.I'll-AERG�AS FRIOR 4MBRANE IINFR 7.JACKEITED 4451
<br /> Ll 90.NONE 0 95.UNKNOWN El 99.OTHER(SPEEify) _ _"SHUT _49.-
<br /> E-1 OFTBALLFLOAT -OFF VALVI
<br /> O�i�,RFILL-IIIJEWENFIO I [-_I 4.-PANICJ11-117MENT-i FOR EXEMPTION FROM OVEKFILL PRbVJ:NTION FQUIPMFNT ..................... -------
<br /> _)N
<br /> V. PRODUCT/WASTE PIPING CONSTRUTT.0
<br /> SjN(jLF WALLED Di�) 1131].E� At�LED ❑99.ffffli
<br /> 0 4.SArESIJ(,TJ0N f23(:(IZ
<br /> URE E] 2.GRAVITY El 3.CONVENTIOI\',\L --
<br /> -----
<br /> _ySr E M_TY P I, TPRESS
<br /> PIPING CONSTRUCTION 116 N 2636(a)(3))
<br /> AL n R.FLFXIBLI� ❑ 1O.RIGIDPLASTIC 4(A
<br /> PRIMARY CONT;�INMFNT ❑ I FIBERGLASS
<br /> 464.
<br /> go.N,01\m, 9.5.UNKNOWN F1 9().O'fliER(Specify):______,_,_--
<br /> VEfIIERGT ASS ❑_TTFTEXIBLF, 10.RIGID Pi ASI
<br /> SECONDARY CONI'AINN CE.Nr D -SF]_TL 464c
<br /> El 90.NONE El 95,UNKNOWN ❑0 99.OT14UR(Specify):
<br /> PIPINGrrURBINF,CONTAINMENTSUMPTYPE,
<br /> 51 I-SING11.13 WALL U 2.DOUBLE WALL 0 90.NONE
<br /> VLVENT,VAPOR,RECOVERV(?R)AT"RISER/FILL PIPE PIPING CONSTRUCTION
<br /> � �4(A.1
<br /> 461c.
<br /> VENT PRIMARY CONTAINMENT E]TSTr.,Ej, 0.RIGID PLASTIC 0 90.NONE E] q9.OTT_IFg(-
<br /> _n
<br /> ____j(_90N0I1TF El 99. )7515R.FS 464f
<br /> Vj-'.NT SECONDARY CONTAINMENT El I.STEEL F] 4-FIBFRGIX'jS ❑ 16.RIGID PLASTIC (Specify) 464fl
<br /> 464e
<br /> VR PRIMARY CONTAINMENT' El [. -4.rTiTf",.AGT,ASS _I 10,RIGID PLASTIC 0.NONF 4G4P
<br /> 464b
<br /> 90.NONE�099-(�Yrfff�l (Sp
<br /> VR SECONDARY CONTAINMENT
<br /> r:, 10.RIGIDPIASTIC
<br /> 4641,1
<br /> 4(Ai,
<br /> VI N'1'PIPING TRANSITION SUMP TYPE ❑ 1.SINGLI,W 2.DOUBT.[!WAT,L 90.N -----------__
<br /> 1.STEEL.- -_- - 90.NONE U 99.OTHER(Specify) 464i
<br /> �71_r 1(T.RIGfDP_ATIC
<br /> RISER PRIMARY CONTAINMENT EL El io;I 4(Ail
<br /> R- E 464k
<br /> STEEL
<br /> RISER SECONDARY CONTAINMENT FIBERGLASS ❑ 10.RIGID PLASTIC 90.NONE n 99.OTHER(Specify) 46*1
<br /> C 4.CONTAINMENT SUMP
<br /> f,_j_(75MI;i5N IN`ff I NST;�6,F,1) 1.SPILL BU 3.S7 IUICFR."PI,ATF/BOTTOM PROTECTOR
<br /> VIT.UNI)ER,DISPENSER CONTAINMENT.(UDC)
<br /> ------- 0 90,NONE 469A
<br /> WALL 2.DOUBLE WALL ❑ 3.NO DISPENSERS
<br /> CONSTRUCTIONTYPF 1,73INGLE
<br /> 10.RIGIDP 469b,
<br /> _4FiBERTL;�SS PLASTIC 0 99-OTHER(Specify)
<br /> _C(_)�jjTRCjCTj(FN MATERIAL.
<br /> VIII. CORROSJON PROTECTION
<br /> 449.
<br /> SI FEL COMPONENTPROTFC'TIOn 1SACRIFICIAL ANODES) Ll 4.IMPRESSED CURRENT 13 6.ISOLATION
<br /> IX. APPLICANT SIGNATURE
<br /> -edand that the informatiOn provided herein is true,Accurate,
<br /> CERTIFICKnON- is system
<br /> ompatible with the huardowis substance stom
<br /> i full n ------
<br /> TJR 4�_&_Og 470.
<br /> APPLICANT SIGNATUR DATE
<br /> APPLICANTNAME(print) APPLICANTTITLF.
<br /> JTPCF UST-H-9/2 Rev.(12/2007)
<br />
|